Below is a Transcription of The Podcast:

Howard: It is just a huge honor for me today to be podcast interviewing Tyson Downs with Titan Web Agency. Titan Web Agency has years of experience working with dentist, helping them meet their revenue goals.

Prior to starting Titan Web Agency, he freelanced in SEO and web design while working in the corporate world. Tyson is a graduate of Brigham Young University, the father of five, and a passionate body builder.

So, you should switch from iTunes right now and go follow us and subscribe on YouTube. He's naked right now on the show if you're listening to us on iTunes.

Tyson created a digital marketing agency that's truly gets it. They understand what it's like to own and run a small business. They understand the challenges that you go through each day because frankly they face many of the same challenges.

They treat you like a person, like a friend, not just another account. They speak to you in terms that you can understand. They get that you aren't an SEO expert. All you want is to get more leads coming in. They aren't a low-price, budget, churn and burn agency.

They like to say, "You can have a quality, you can have low price, but you can't have both." If you're in need more patients and are considering a marketing company, consider Titan Web Agency.

What I want to say before we let the man talk is that overhead, I mean, the simplest way to look at overhead is that if your costs for a year are a dollar and you do a dollar's worth of dentistry, your overhead's 100%.

So, what do you do? You try to save money on supplies, and you try to not give raises or bonuses, and you just try to cut down that cost, but if you raise your cells to $2, now your overhead's 50%. And watching overhead...you know, when I got out of school 30 years ago the average dentists had 50% overhead.

Now, they have over 65% overhead, that's two-thirds. And the bottom line is you're signing up for all these PPOs, which are lower prices. Every time the Earth goes around the sun all the staff want a raise, so your overhead's ticking up.

And usually, the way to solve overhead is patient flow equals cash flow, you get in more new patients, you market, you advertise you get in more patients, you do more same day dentistry. When you tell someone they have a cavity, always ask them if they want to do it now. You have extra rooms, you'll work through lunch, you stay late.

But Tyson, I know my homies, every month they don't go bankrupt. Dentists only have a .4% bankruptcy rate. Hell, restaurants have a 20% bankruptcy rate the first year. The only way a dentist goes bankrupt is he gets his license taken away and that's about 85% of time for alcohol, 15% for opioids. So, they're not gonna go bankrupt.

So they paid their rent, mortgage, equipment, build-out, computer, interns, malpractice, professional dues. They've paid all their bills, so that one more new patient that month is pretty much nothing but net income gravy. And all they want is 10 or 15 more new patients a month. What do you do when a dentist calls you up and says, "Tyson, I need 15 more bodies walking' in this door each month?"

Tyson: What we like to do is like to have a strategy session with them. We like to find out the why of course, you know, why do you need this, where you at now, and where do you want to be? So, once we understand that a little bit more, we can understand this strategy to approach that.

You know, if they're having a hard time paying their bills and bringing any money home, then we know this is pretty urgent, we need to start getting some new patients and right away. Whether that's through some Google ads or some focusing on emergency dentistry or whatever it may be.

But the why, I think, is a big thing that a lot of people don't go into. So, if we understand the why, you know, we can help the dentist get there a little bit quicker.

Howard: Well, what are some of the whys that you're seeing in the field?

Tyson: So, I'll see from...you know, I'm working two jobs right now. I work in a corporate practice and I'm trying to stay here at my own practice three days a week. And obviously, the why there is, you know, he wants to be his own boss, he doesn't want to have a corporate boss anymore.

And so, in cases like that, you know, I work with him and say, "What are you doing as far as networking in your community?" You know, that's a big thing when somebody goes to a dentist, if they've seen you around the community, seen you promoting different events, maybe a local Little League or something like that, that's gonna go a long ways.

Another why is, you know, "Tyson, I've been doing well over the past few years, but I see a dentist down the road that seems to be doing a lot better." So, you know, sometimes it's a matter of ego. They wanna be the best, the most well known in the town. So, it's kind of depends on who it is and what their goals are.

Howard: Yeah, dentists are competitive because for four years, you know, I mean, all through college, I mean, you know, you take a chemistry test in undergrad and then they post the 40 answers, you know, A, B, C, D on the back and everybody's, they're competitive because in undergrad only the top 10% got to go on to med school, dental school, and law school. And then they get into dental school and only the top 10% or 15% get to go on to grad school or whatever. So, they're extremely competitive.

But tell that guy working three days in one place and two days in another to grow a pair of stones and you dive...you can't pretend to learn how to swim by crawling along the side of the swimming pool with one hand and one leg in the water.

You just dive in headfirst and remember, nobody goes bankrupt unless you have a substance abuse problem. And if you do have a substance abuse problem just go get that fixed, go work on that, go be an associate somewhere and go to treatment, get fixed, and then dive in headfirst.

One of the things I really loved reading on your site, you say...by the way, his site is titanwebagency.com, titanwebagency.com. By the way, where'd you get the name Titan? Is that related to Tyson?

Tyson: No, it isn't. And actually, if I would have thought about it more and seen how closely those two are, I probably would have went with something else. But I like the name Titan just because it feels strong and mighty but, you know, hindsight's 20/20. It is what it is now. And so, you know, I'll stick with it.

Howard: Well, why didn't you go Tyson Web Agency?

Tyson: Well, you know, I was...it was just me for a long time but I built a team of about 10 that work with me on a consistent basis and I didn't want to be seen as the only person in the company that can do anything.

So, I have an account manager that manages the accounts with me and I don't want somebody when they come to me thinking, "Oh, well, I thought you were gonna do everything for me, Tyson?" Well, you know, that's not realistic when I have a number of different clients.

Howard: Well, great minds think a lot because that is why I did not call my dental office Howard Farran, DDS. I said, "If I'm gonna go out and build this big brand, Howard Farran, everyone is gonna call my dental office and want me." And I felt like graduating dental school is like being given a lawn mower, I didn't want to push a lawn mower for 65 years.

So, I went with Today's Dental because the number one thing was they can't get into dentists, like right now in the United States, it's a five-day wait to get into a dentist if you're an existing patient or new patient. And 8.5% of emergency room visits are odontogenic in origin because they can't get in their dentist.

So, I went with Today's Dental, because I wanted to build that big brand, so they call that phone and then if I'm in they could give them to me and if not...But you said, "71% of people click on page one search results, 88% of consumers trust online reviews as much as a recommendation of a friend, 93% of online experiences begin with a search engine, 77% of patients search online before booking an appointment."

But this is what I think...the other thing that you said, let me see if I can find this so I don't butcher your words. But basically, I'll just butcher since I can't find it in your website. That, you know, I see all these people doing all these Facebook posting and the other, just Facebook, Facebook, Facebook, and that's interesting but that's not when they're looking for a dentist.

I mean, it'd be like, I don't know, let's say I need a bypass one day. So, I could be glossing over all these heart doctors or whatever doctors or whatever but that ain't today. So, it's very different when you just broke your tooth or you got a toothache this morning or your brushing your teeth and found a hole in it and you want a dentist.

That's a very different human behavior than just surfing your Facebook pages and seeing all these ads fly by, correct? Or same with television ads.

Tyson: Exactly. You know, I think that Facebook can work for certain demographics and certain dentists that have very specific goals. However, I always tell my clients the best marketing strategy is a diverse one.

So, if they want to test Facebook, fantastic. Let's test it, let's throw maybe a couple thousand dollars over three or four months and see what happens. But let's not just put all of our eggs in the Facebook basket or even the Google AdWords basket, even though Google AdWords can be extremely effective.

You know, I work with a few different drug rehab centers and what happened, Google started restricting the keywords by about 90%. And so, these rehab centers that have been spending $20,000, $30,000 a month on AdWords, all of a sudden, you know, they were bidding on everything and could only spend 5,000 or 6,000 a month on AdWords max because everything was filtered.

So, that's part of the reason why we want to have a diverse marketing strategy and see what works. Once we find out what works, you know, that's where we put most of our focus, time, and attention, and then fine-tuning that even more.

Howard: You know, you homies out there, every time I see a report come out on dentists and substance abuse, they pretty much mirror the population, about 14% of Americans have substance abuse issues and that's about the population. So, dentist I've never been really higher or lower, same with the divorce rates, they're always the median, the mean. But I'm really proud because I'm Irish, 100%, and in Ireland, 38% are alcoholics.

Tyson: Wow.

Howard: The only people that beat us is Russia, those damn Russians are 40%. My goal is someday that the Irish get to 41%. I don't know if I share that with Google AdWords. Yeah, so Ty, you know, the dentists...talk about the difference between putting money into your website for organic search and reach and all that, versus just paying for it.

And you know, one, you earn it. I always asked like making love to your girlfriend whereas, one, you pay for it. What's more effective? Pay-to-play or earning it at home with your organic...with a great website?

Tyson: I'm gonna give a very on-the-fence answer, both of them work and I think that both of them should be used. Reason being is you want to build something up that's gonna last for a long time.

So, you want to build up a good strong web presence and that's through a website that provides a great user experience that gives us this visitor what they want, that the search engines can read and understand. You want to become, I tell my clients, popular online. Meaning you have people that are referencing your site and linking over to your site that's gonna help in the search results.

But that can take, you know, in competitive markets, that can take months or maybe even years if your competitors are doing a good job to get where you want to be. So, in that case, that's where you really need to be using other avenues whether it's Google ads, or postcards can be extremely effective.

Getting into Facebook and seeing what you can do there, but you shouldn't rely just on one avenue. But it's always, always a good idea to start sooner as opposed to later with your organic presence.

Howard: You were in Utah and I've seen several, several reports that Utah is the most crowded of the 50 states, and it has the lowest dentist to population ratio of all 50 states. And you work with clients all over the United States, correct?

Tyson: That's right.

Howard: Because these young kids...like I got two dental schools down the street from me, Midwestern, and Glendale, and [inaudible 00:12:24], and Mesa, and a lot of my Mormon buddies are like, "Well, you know, I wanna go home because, you know, that's where Mom and Dad are," and all that stuff. Do demographics matter? I mean, when you're working with clients around the United States, are people in rural areas less likely to be a client because they don't need your services? Do you have more clients in Utah because there's a dentist on every corner? So, I'm saying do demographics matter or did you go in the most crowded place and just out-market advertise SEO and search everyone?

Tyson: You know, I have, let's just say, clients all over. I have some clients in Utah. I have clients in a number of other states, clients in small markets, clients in very large markets. And, you know, what the difference is, you know, the basics are the same, we need to make sure your website is up to par, that it can be read, that you get your good, local SEO on that.

But the main difference is how much you need to spend. I have a dentist in Houston and he is brand new and he wants to rank number one, great, okay, great, that's a good goal. However, Houston's a large area, other guys have been marketing for 10 years. So, let's be realistic, what do we need to do?

How about we start going after the close neighborhoods to you. One, that's gonna bring in more localized and more targeted visitors to your office. But two, we'll be able to get quicker results as well.

So, in bigger markets, yeah, you're gonna probably have to spend more because everybody else is spending more unless you have some type of a magic formula, which people promise but they never actually have. You know, it's realistic that you're gonna have to pay more because everybody else has that strong presence and has done it for a while.

And some smaller markets, you know, there's not much competition and a lot of dentists haven't done anything besides put up a website. And in cases like that, you know, I've had dentists come to me and just need to have a new website and have it optimized, have the Google My Business set up properly and get a few citations set up.

And that's all they need and they're still number one in the three pack. So, it varies heavily but, you know, those competitive markets, you know, it's gonna take some money to make some money.

Howard: Yeah, and by the way, kids a lot of time, you know, when you get out and you start your practice and these people will brag that, "Oh, I'll give you the, you know, first page on Google. I'll get you the first blah, blah, blah, blah." Well, hell, if I Google "Howard Farran, DDS," I'm gonna be the only result. So, it's really hard to ask what page one is because you don't know what they're gonna be searching.

Tyson: Yeah, and that's what I see is a problem in our industry is people will say whatever it takes to get the business. When I talk with a client, I'm basically interviewing them as well to see, you know, are we a good fit? Do I think that they're gonna be on me checking all the time, "My rankings aren't here, my ratings aren't here, what's going on?" You know, if that's the case, you know, I'm not gonna do business with them.

They need to understand the big picture and I try to set that expectation right from the get go. You know, it's gonna take a while for the work that we do to be seen and recognized by the search engines, and for us to make some progress. But I set a good timeframe for what I expect to happen and show them how we're gonna track the leads that are coming in so they can tie that investment that they're making back into their return.

Howard: Everybody's saying that search is rapidly changing right before eyes going from texting to voice. And you know, back to my reading Peter Lynch, "Beating the Street," Wall Street, you know, all my economic training is Peter Lynch.

You know, I can just hear his voice saying, you know, "To look at these national stocks and you live in Omaha, well, how is that restaurant do in Omaha?" I remember analyzing a Boston Market 20 years ago, and I did what Peter Lynch said, I kept going there and eating and seeing all the happy customers and all the stuff like that.

And I've noticed within my circle of friends that people are now, when they pull up that Google in the smartphone, they're not getting their big meaty thumbs out, they're hitting that little voice icon and they're talking into it. Do you think that's gonna change...do you think that's gonna have a material impact on search?

Tyson: I think it will. It's really hard to say how it's gonna affect local search. I know that it's affecting search on Amazon on Alexa, you know, drastically. If you tell, Alexa, "Hey, order me some, you know, some XYZ," she's just gonna order what's the first result.

So, I would anticipate that it would start to go in the same type of a direction with Google. You tell Google, you know, "Where's the closest dentist?" or, "Who's the best dentist in my area?" then something similar is gonna be happening and then that's where it's ever so important that you show up well in the search results.

Howard: Yeah. Gosh, I almost died because when I called the ambulance, I said, "Siri, call me 911," she says, "Hello, 911." And she just changed my name. When I got out of school the big ones were going in retail instead of medical/dental building, big pages in the phonebook, and direct mail. And now the phonebook, I declare dead, I mean, I don't know anybody...I've never seen anybody use it. Now, everyone's in retail on every corner. The phonebook is dead. Is direct mail dead too?

Tyson: I don't think so. You know, it's not a service that I offer but it's a service that I'm a big believer in. You know, I've done a lot of research and work with a lot of dentists that use direct mail and if done right, you know, it can be extremely effective.

My opinion, the best way to do it is to do oversized postcards, and if you're on a budget you can do every door direct mail, what they call it EDDM, and that is through the U.S. Postal Service. That ends up being much cheaper.

Howard: EDDM?

Tyson: That's right.

Howard: What does that stands for?

Tyson: Every door direct mail. So, you'll select a zip code and then it will go to every door within that zip code.

Howard: Yeah.

Tyson: But the best way to do it is if you can buy a list, you know, most important thing when you're sending out direct mail or sending an offer is having a good list. If you don't have a good list it doesn't matter how great your offer is or how pretty your postcard is. But if you can get a good list of new move-ins in your area, new homebuyers, whatever it may be, and send a direct mail to them, then, you know, you're gonna be getting some results.

And it's not just one, you never just send just one, you're gonna send one after another month, and then after maybe three months, and another one six months, and make sure that you're tracking that. That's where so many fall short is they're not tracking the calls that come in.

And that's as easy as ordering a call tracking number and then you don't have to ask people, "Hey, how'd you find out about us?" You don't have to have a very unique offer on that. You can just have your regular offer and if they call that number then it shows up in a report. And you see how many calls and appointments that generated.

Howard: You know, one of the reasons television is dying is not only are people under 50 just not watching it, but you know, when you sit there and you're trying to watch a news program and every 10 minutes and you get 4 minutes of commercials and none of them are targeted. I mean, I don't want a little chair device that's gonna carry me up to the second floor.

I don't have restless leg syndrome. I don't want a class-action lawsuit. It seems like media's gone from...back when I was a kid with just ABC, NBC, CBS, they just blanketed these big consumer packaged goods products that maybe everybody would want to eat oatmeal or Captain Crunch or whatever, but as it gets digital people really gotta think about targeting.

So, my first question is like, if I was a dentist and I want to do a lot of implants on Grandma and Grandpa, I would think that more likely they'd go to their mailbox to get a direct mail than find me on Facebook or Google, is that true or false?

Tyson: Well, I agree with 100% there. Now that isn't to say that we don't use Google because you want to find people searching, but yeah, Grandma and Grandpa are gonna...you're looking at the mail a lot more and on the computer less.

And then if you do some ads on the internet, what about using Bing at that point? Because what's the default browser on most computers that Grandma and Grandpa use? It's Internet Explorer. And what's the default search engine? It's gonna be Bing. So, at that point, you know, it's a little bit more targeted and if you get more targeted, you can get the better results we talked about.

Howard: Man, that is profound. I've never heard anybody say that, and that is so obvious. If you're going after Grandma and Grandpa, you're right, they would be on Bing, they would be on Internet Explorer.

That is true. So, what about if you were, say, an orthodontist or a pedodontist and you wanted the kids, but the kids aren't gonna make the appointment?

I keep reading things from people like Regina Herzlinger, who's a DBA, a doctorate business administration from Harvard University in health care economics. She's been saying for 30 years that Mom makes 9 out of 10 appointments. True or false, you believe that?

Tyson: That's how it is in our house, you know.

Howard: Yeah.

Tyson: I agree 100%. You know, I'm busy, busy working and Mom is extremely busy too but, you know, she kind of picks up the slack there and sets those appointments and takes the kids to the appointments. So, yeah, I agree 100%. And so, in cases like that, you're gonna want to get in front of the moms.

Howard: Or how our mom's different on social media? I mean, I just read the other day from professor Scott Galloway at NYU School of Business saying that YouTube was 80% males. Do you think moms...if this is a female industry, which it is, I mean, 30 years, I can vouch if a guy like you walks out I say, "Hey, Tyson, you got five kids, I'm doing their insurance. Real quick, give me the birthdays of all five of those kids." I mean it's like deer in a headlight.

I mean, you know, they don't know any of that information. Mom always brings in the insurance, she always knows the birth date, she knows all that stuff. How would finding Mom on social media be different than finding Dad?

Tyson: Obviously, Facebook would be one that you'd want to look at that point, and with Facebook advertising you can get extremely detailed in what you're going after. But I wouldn't just leave it to social at that point. When you're doing perhaps Google AdWords, you would maybe want to speak a little bit more Mom language.

You know, maybe talk a little bit about how easy is to set up the appointment so they can save time during their day or get time back during the day, whatever it may be. So, you want to speak their language and, you know, look at local networking events where it's more women. You know, where do women go for local networking events, you know, and can that orthodontist's office perhaps have some type of an open house or a tour for preschool?

And I know that may not be the biggest thing that's gonna drive business but it's these little incremental things. I read this book called "The Slight Edge," I can't remember the author of it right now, but "The Slight Edge" talks about how you're doing these little things every single day.

You're not seeing much happen at first, but over time you look back and you can see, you know, a profound change. And so, if you're making, you know, an effort to do networking events on a regular basis to test out different marketing efforts, you know, then you're going to notice a big difference over time.

Howard: So, if they go to your website, titanwebagency.com, there is a place there where you can download, get a complete overview of your local SEO performance and minutes, search rankings, local listings, reviews, on-site SEO, social media, simply enter your business name and we'll do the rest. Talk about that report.

Tyson: So, that's a report, we use very special software that goes and looks up your business and it puts in...you put a your information and then we pull back what you're ranking for, the different keywords you rank for, and we scour the web and look at references over to your site. Are you listed on Yelp?

If so, you know, is that information correct? What's your Google My Business information, is that correct? And we let you know where you're ranking and how you compare versus some of the competition. The main thing is, you may think that you're doing well but, hey, go run this report and we'll show you some areas of opportunity where you can improve.

Howard: And that usually does?

Tyson: Oh, absolutely. I mean, I would say that anybody that's run that report has come away with something that they can do better. For example, we'll give it an on-page SEO analysis. For those that aren't technical that means we'll look at your website, basically how the search engines look at it. And then show you where there is things that could be fixed.

It could be as simple as, you know, your website right now, the title tag may be says, "Home." I see that on a regular basis and we typically don't want that. We want it to say something like, you know, "Dr. Baxter, Salt Lake City dentist." We want it to be more descriptive so the search engines can read that. And so, that report will give you an idea of what's missing and what needs to be fixed.

Howard: And what else are they gonna find on your website, titanwebagency.com?

Tyson: We have a number of different reports that are available that can help them improve their performance for their Google AdWords, help them improve their SEO. We have some patient care forms and we I actually have a...if you don't mind I'll give a website they can go to where we're gonna give them a very comprehensive website audit, that's getmyaudit.net. They go to getmyaudit.net, that's my site, and fill in their information and we'll provide a report.

Howard: Getmyaudit, A-U-D-I-T, A-U-D-I-T.

Tyson: That's right.

Howard: Getmyaudit.com.

Tyson: .net.

Howard: Oh, .net, okay.

Tyson: No, put in their information and we'll send them over, within a couple business days, a very comprehensive analysis of their web presence and their rankings for their important keywords.

How is your website performing? Are you paying for little to no results? Do you know where your website is missing the mark? How would you like to get a free SEO report analysis that contains all the information?" I want to talk...I'm going to switch gears completely to reviews.

Bottom line is, all honestly, I'm 55, all my buddies that I go hang out with and watch the Cardinals and now the Diamondbacks who haven't won a game this month, and the Cardinals football quarterback coach, our quarterback is ranked 30 out of what...is it 32 NFL teams or 36?

Tyson: I was thinking it's 28.

Howard: How many teams are there? Yeah, well, Phoenix, Arizona Cardinals has the prestigious ranking of number 30, which means that I might be able to get a job. There's 32 teams and we're 30, so it's gonna be a depressing deal. But I've never seen anybody use Yelp or get a review, I mean, I've never...when I go lecture, a bunch of dentists say, "Hey, you want to go here, you want to go there?" There's four or five of us in a car.

I've never in my life one time seen a 50, 60, 70-year-old dentist say, "Well, let's read a Yelp review before..." you know, I mean, I've just never seen it. Is that because I'm a grandpa and have four grandchildren and this is a millennial thing, or is it a San Francisco thing that doesn't happen in Kansas? You know, back to that Peter Lynch thing, I mean, he keeps saying, you know, "Howard, look at this business in your backyard.

Don't look at a Wall Street analyst." The richest stock investor in the world is Warren Buffett and he lived in Omaha purposely because he didn't want to listen to all the bullshit in Manhattan. So, sell me, Tyson, never seen it, never seen it.

Tyson: So, this is what I tell the people that are wanting to work with me or that I work with, is your ideal customer, your ideal patient isn't you. So, don't make your decision on what needs to happen because of a conception, preconceived notion that you have. You don't use them, okay, but does that mean people don't use Yelp? No, it doesn't.

There could be a ideal patient that wants a $50,000 smile makeover and they use Yelp. So, are you gonna get on Yelp or not? So, yeah, there's things that we need to do, even if we don't personally use them and we need to, you know, be able to swallow our pride and say, you know, "This can be a potential avenue for success for me and I at least need to look into it." You know, I have a psychologist that I work with, she's like, "No Yelp.

I have beliefs and they don't fit in that belief system." Okay, no Yelp, that's fine, but people will go and search for a psychologist on Yelp, they do. And if you're not listed on Yelp or if Yelp creates a listing for you and there's nothing on there then, you know, you're gonna be negatively impacted.

So, don't have these beliefs that because you don't do something somebody else won't. And that kind of goes along the lines of when I work with these clients, I'm building your websites, they sometimes think, "Well, my website needs to do this, and this, and this, or look specifically like this because that's what I like."

Absolutely not, your website is not for you, your website is a storefront, your website is a 24/7 salesperson for you. So, let somebody that's objective, such as ourselves, make these recommendations on what needs to happen on your website. You know, and then we can make some tweaks so that you're happy with it as well.

Howard: So, we put this podcast on DentalTown but I also own OrthoTown, and the magazines mailed each month to 10,800. I've always noticed the orthodontists are twice as intense marketers than the general dentist. Do you think it's because, you know, the average Invisalign ortho case is $6,500 whereas the dentist, he's gonna get a new patient, it's gonna be a cleaning, exam, and x-ray and a couple fillings?

Have you noticed that with orthodontists? Because you say you serve the industries of dentistry, plastic surgery, physicians, health care professionals, orthodontists, drug rehab, psychologists, physician groups, accountants, and lawyers. So, tell me the difference between your dentist clients and your orthodontist clients.

Tyson: The main difference, you hit the nail on the head, is, you know, these typical cases that are coming in for an orthodontist are higher in value typically, not always, but you know, generally they are.

And so, they're willing to usually spend, you know, a lot more money because, hey, you know, I can spend $4,000 a month, you know, if I'm going to be able to get, you know, a three-time return or a two-time return or whatever it may be.

So, just because a higher lifetime value seems, you know...and a lot of orthodontists that I talk to seem to be...and this is generally, seems to be a little bit happier, really enjoy the work that they do. And maybe it's because, you know, there's such immediate differences visually and they can see their work.

Howard: So, you noticed your orthodontist clients are more happy in general than the dentist, general family dentist?

Tyson: Very small sampling and purely anecdotal, but that is what I've seen.

Howard: Yeah, do you think it has something to do with the fact that they don't give shots, there's no drilling, there's no surgery, there's no blood, there's no gauze, there's no surgery, there's no infection, there's no antibiotics, there's no pain meds, it's just glue and rubber bands? Do you think that might be...

Tyson: I think so.

Howard: ...a huge part of it?

Tyson: I agree, yup.

Howard: When's the last time an orthodontist got an infection, a dry socket, a swollen face? Yeah, so they're generally happy. What percent of revenue do you think the average orthodontist does spend and what do you think the average general dentist does spend, as far as collections, percent of revenues spent on marketing and advertising?

Tyson: You know, I don't get into to it with them at that level, and I don't because it's not necessarily...that part of it isn't my business. If they're brand new coming in and they haven't advertised much before, a lot of times they're like, "Tyson, I don't really know where to start, what can you recommend?" And I'm only gonna recommend something that I know is gonna help, gonna work for them.

And so, I'll try to find out, you know, best-case scenario, you know, if you could get X amount of patients per month, how much would that be worth to your practice? And once they give me an idea on that, then I'll let them know, "Hey, yeah, I think that we can work together."

But as far as the percent of that, you know, I've heard 8% to 10%, 10% to 15% but I don't get into that with my clients. I let them, you know, keep that part private.

Howard: Do you get into about the cost per head to get a new patient from what your services does about what it costs per person, per head, per capita?

Tyson: Some of them, I do. Actually, there's just a couple of them that do. They're like, "Tyson, we need our leads to be at about X dollars per lead that we have coming in."

Howard: And what dollar are they saying?

Tyson: For leads coming in, they're saying between $17 and $20. A new ad meant to be $80 to $100, which they're a very high volume at this.

Howard: What was $17 a head and what was $80 to $100 a head?

Tyson: Leads, so about $17 to $20 and then...

Howard: Seventeen to $20 for a lead?

Tyson: Right.

Howard: And $80 to $100...

Tyson: No, because a lot of them aren't gonna be qualified.

Howard: And what?

Tyson: A lot of them won't be qualified so, you know, that's why that cost per lead is less or they won't close all the leads that come in.

Howard: And how much for a closed lead that comes in, what would that number be?

Tyson: This particular one that does a lot of high volume, they're looking at $80 to $100, which I think is pretty low. You know, they've told me that their lifetime value is $5,000 per, first-year value is about $1,250. So, you know, if they're willing to pay $80 to $100, I think that's pretty low. I think most would probably pay a little bit more if they're gonna be getting into patients.

Howard: What do you think the average dental office is spending to get a confirmed new patient?

Tyson: Good question. I'd probably say in that $100 range.

Howard: Hundred-dollar range. The point I'm making, so you said something very profound, the average orthodontist, you know, their average new case is $6,500 for braces, Invisalign or whatever. But he realizes that income in 24 months, 2 years treatment, and a lot of them got the treatment down to 18 months.

The dentist's value of the patient, actually, is the same as that number. But they don't realize it. They realize it over 60 months. So, the dentist is gonna get $6,500 out of this patient, but it's gonna take 5 years. The orthodontist is gonna do it in 18 to 24 months. And then when you look at that $100 a head, the most amazing marketing ever done, and what was used for every dental office I know that's in the $3 million to $4 million a year collection, was mergers the acquisition. So, he's saying $100 a head.

So that guy across the street is retiring from you and you say, "Well, how many active patients do you have?" And he says, "Well, I got 2,000." Well, you got 2,000, what's 2,000 times 100? You know, and then you say, "Well, yeah, I'll give you a check for that," and then you go away and I move those charts in the office because that city used to have five dentists and now it has four. And then five years later another old guy, and now you're down to three.

Look at the reverse of that, Tyson's got five kids, I have four kids. Imagine that old man, and you don't buy it and roll those patients into yours and reduce that town from five dentists to four. And now some young, hungry, 25-year-old Mormon dentist from[inaudible 00:37:00] who wants to go out and have five kids, who's gonna work his butt off seven to seven, five-and-a-half, six days a week, do the parade, do the market, I mean, you're trading out Grandpa for someone who's carrying around about 1,800 milligrams of testosterone for decaliter and is 50 years your youth, and it's just the most brilliant strategy in the world is to buy out the old bulls that are turned out to pasture and roll them in.

So, a lot of times when you look at those patients, you know, listen to this guy. So, if you didn't buy that practice, now you're gonna have to take that practice money and give it to Tyson to get the patients. So, these are confirmed patients that have been in the office. The only thing it comes down to is what is your definition of an active patient?

But I want to go back to reviews again because I do...everybody keeps talking about it. What do they call it? Social confirmation. And we're only dealing with moms who make, you know, 90% of the appointments, Regina Herzlinger thinks it's upwards of 93%. Do you think moms need social confirmation for purchase more than dads?

Tyson: Oh, that's a tough question because I think about it. I'm gonna look online more, myself, and I can only judge it based on me. I look online more myself and talk to friends less.

My wife, she'll look online and look at reviews but she'll talk to friends too. She's just more social than I am. So, I think that women are gonna, you know, get the recommendation of a friend probably little bit more than a man would. A man would just, "Oh, five stars, okay, let's book something," if they have to, or, "Oh, wife, I found a good dentist, he has five stars here, why don't you book an appointment?"

So, I think men probably rely on the internet just a little bit more for that proof and women probably speak to their friends a little bit but, you know, that's a guess and I could be completely off.

Howard: No, that's what everybody's saying. I mean, the anthropologists are saying that when they study apes and monkeys, humans, gorillas, chimpanzees, orangutans, bonobos, gibbons, and all the monkeys, that every time a boy monkey talks to another monkey, the woman will talk to five, it's a five to one ratio.

The University of Chicago does studies on how many words we say a day. Every year they've done it for 20, 30 years women are always north of 7,000 words a day and men are under 1,500, which is why they like YouTube, because they don't want to say anything they're just gonna listen to a one-way lecture, which is a very different experience than getting on Facebook and making a comment and all your girlfriends are replying and commenting, you're going back and forth and private message.

And I saw that with my five...I grew up with five sisters, I mean, they were just obsessed, you know, they had best friends and girls that used to be...you know, you got five kids, how many boys or girls?

Tyson: Three boys, two girls.

Howard: And what are their ages?

Tyson: Well, I just have a little princess that turned 5 yesterday, and then I have a 9-year-old boy, and a 12-year-old boy, and a 15-year-old girl, and a 17-year-old boy.

Howard: Yeah. And it's a small sample to say. I mean, you could have a shy, introverted girl, an extroverted boy, but the girls are just far more social. So, maybe that those social groups...so, how does the...I know what my dentist is gonna think. There's no way he's gonna say, "Hey, Tyson, can you do me a favor? Could you leave me a review?" I mean, they hate that stuff.

They don't ask for referrals. You know, I've talked to...I podcasted pretty much every dental consultant I've ever met or I dinner with and the one thing they all agree on 100% is, you know, the first day they just go in the office and observe. And when they observe, you know, some office are doing this or that but no one's ever observed asking for a referral or a friend or loved one on day one.

It's never been observed. And it's just so counterculture. So, my question is how do you get more reviews? I mean, he's not gonna ask for one.

Tyson: So, the dentists that we work with, we help put together a review system for them and they can...there's a link on my website in that menu, Get More Reviews, and they can learn about that system. But, you know, there's things that I don't like to do for my business, I don't like to have, you know, phone calls that take hours at a time, or clients that want to continue to talk about stuff that we've already talked about in an email.

There's things that I don't like to do but, you know, I do it because I know that it's best for my business. I see dentists that I work with, they do awesome, awesome at getting reviews. And without fail what that is, is that at the end of the appointment the dentist, you know, just asked a favor and said...they're getting ready to leave and they're like, "Hey, do you mind doing me a favor? You know, we're trying to get the word out about our practice and if you could leave a review on Google, you know, just take a couple minutes, I'd really appreciate it, and Andy at the front desk has more information."

So, if that is specifically said, ask for that review on Google, let them know that you're looking forward to reading it. Now, a lot of stuff I've gotten from Maui Bob on the DentalTown forums, that's gonna greatly increase the chances of getting that review.

And the front desk says something about it, and then your practice management software sends out that request for the review whether it's through text message or an email, and then maybe you send out a postcard a few days later too. But you have to ask it. There's things that you don't like to do that you...

Howard: Who'd you refer to on DentalTown?

Tyson: Maui Bob, he has a review system and he helps dentists get more reviews.

Howard: Spell it, M-A...

Tyson: M-A-U-I.

Howard: M-A-U-I.

Tyson: Maui Bob.

Howard: Bob Summers [SP].

Tyson: That's it, yup.

Howard: Yeah, Bob Summers. Now, I got you.

Howard: I've read that there's a lot of Google cracking down, Yelp cracking down on people saying, "Leave us a review and I'll give you a Starbucks gift card," or trying to bribe people to give reviews. All my reviews were done by my five sisters and they each have five friends. So, I was able to build all my reviews just through family and friends. What do you think of that strategy?

Tyson: Yeah, the most recent thing Google has said, "You don't want to gate reviews," meaning you don't send somebody to a landing page and if they click one star or two stars, filter that review into a feedback form.

That's been the general practice for quite some time. And Google saying don't do that, you know, if you do that then you can get in trouble. So, sure, ask for Google reviews, but don't offer them anything for. And Yelp has said don't ask for Yelp reviews at all. So, I think that the best way to get Yelp reviews is to have a decal on your door that says something, you know, "Check in on Yelp," or, "Yelp customers love us."

And if they check in on Yelp then they're gonna get a request on their phone to leave a review. I mean, as far as Yelp goes, that's about it. Yelp watches where people come from leaving a review, so if they see they're coming consistently from one specific site then they know that you're asking for Yelp reviews and they're gonna start filtering them.

Howard: When I look at Bob Summers' "Get More Reviews," that was a episode 483, you said the word door. I have always put a box of business cards up on my door and, you know, I'm in a retail center. I'm in a center with a Safeway and a Pizza Hut and a Chase Bank and a tanning salon. I think the tanning salon, that's got to be the bizzarest [SP] business, I mean, we're only like nine miles from the sun, and there's a tanning salon on every single corner in Arizona.

But, my gosh, I'll probably grab a card once a month. You know, you're out for dinner, you're out this, and you're like, "Oh, look at this store, this is cool," and you know, you could take a picture on your cell phone but it's really nice when you just have a box of business cards by the door and you just grab that.

Tyson: I think it's a great idea. It's something that most people don't do but it's just those little things like that, you know, is it gonna get you five patients a month? No, but could it get you one patient every two years? Yeah. And what did that cost you? So, absolutely, I think something like that is a great idea.

Howard: And every time you gotta go with the family to the grocery store and you're in there, I always walk back to the pharmacy and press the flesh of the pharmacy. You know, "How you guys doing?" You know, I mean, because people are always going up to them and saying, you know, "What's best for a toothache? Would you recommend Ambesol or Excedrin or Extra Strength Tylenol?" They go, "No, I recommend Howard," and they have my...and then my business card is in my wallet.

That's another thing with dentists. Every time you ever ask your dentist for a business card, they're like, "Oh, I don't have one." Okay, well. you're with your wife, does she have them? How come she has 1,400 things in her purse and none of your business cards? And when you say you don't like going to the grocery store, why don't you go hang out with the pharmacist for 20, 30 minutes and make sure he's got your cards in the drawer, and just keep pressing the flesh.

I wanted to ask you, you do dentistry, plastic surgery, physicians, orthodontists, drug rehab, psychologist, physician groups, accountants, lawyers. How is dentistry or orthodontists different from lawyers, accountants, physicians? Have you learned anything over the years, how we are unique or things that we don't do that the plastic surgeons do, or the psychologists, or whoever?

Tyson: I have seen...dentistry can be a little bit trickier. And probably 80% of my clients are in dentistry, so that's where the majority of my time is.

Howard: Eighty percent?

Tyson: About 80% are dentists. So, that's where majority of my time is spent and it's a little bit more complex at times. Mainly dentists and then attorneys, usually because they have duplicate Google listings. You know, they have perhaps a listing for the practice name, a listing for their own name, and then one of their listings is getting filtered out and they're not showing up well in the search results.

And if you just have a general SEO person come in that hasn't worked with dentists or attorneys before, you know, they could royally screw things up when typically, you know, it's a fairly simple fix to make sure that your proper listing is showing up. So, that's one thing that's unique that needs really to be addressed by somebody that has the experience.

Howard: You know, they always talk about in business...I mean, are you a fan of "Shark Tank?"

Tyson: I've watched it many times, yeah. I actually listen to a similar podcast called "The Pitch," that's from Gimlet Media, so if haven't listened to that, I'd recommend that.

Howard: You should post that on DentalTown.

Tyson: Yeah, I will.

Howard: But, you know, what is your unique selling proposition? What makes you unique? You know, Mr. Wonderful would say, "How come I just can't go give some other kid half the money and just do this myself?" How can a dentist or an orthodontist...or is it even important to differentiate themselves to be different?

You know, when people say, "Well, damn there's a dentist on every corner." Okay, well, are all the dentists the same on all the corners? How would you recommend that these kids differentiate themselves?

Tyson: I think the first thing is they need to really define their target demographics. Once they define that, you know, then they're gonna be able to do develop a unique selling proposition that speaks to them.

You know, are you going after primarily cosmetic cases? Okay, if you are, you want those higher revenue patients, great. Then how are you marketing to them? You know, are you marketing to them as, you know, just another one of their group and a friend? "Come on down, we'll take a look at you. It's gonna be a spa-like environment." You know, what is it? So, you need to really dive deep, define your target demographic, and see what resonates with them.

You know, when I work with clients, you know, I've had people say, "Well, Tyson, there's nothing really different about my office. You know, I'm..." and part of me appreciates their honesty, the other part of me is kind of frustrated because there has to be something.

Why else is somebody going to choose you? You know, maybe you're the dentist that's open until 9 p.m., maybe you're the dentist that has a clown come in on Wednesdays, I don't know, whatever it may be.

You have to do something that's unique, that draws extra people in. So, that's a discussion that I have with my dentists and, you know, a lot of them take it to heart and will come up with something, but unfortunately some of them don't. They just want to be another dentist, you know, among a sea of dentists.

Howard: When you study social media, 1% of your friends on your social media whether it be, it doesn't matter what is it, could be Facebook, Twitter, LinkedIn, Instagram, DentalTown, 1% start all the conversations, 9% engage, comment, reply, whatever, 90% just lurk.

They're just a social animal...fear of public speaking. My God, it's like, they get on stage, they crap their pants. So, when they get a bad review, I swear to God, you have to walk them off the cliff. You know, they're calling you from the San Francisco Gate Bridge and then they're either angry and want to get a lawyer and sue them, or kill them, or shoot them, or...so how do you handle negative reviews especially since dentists just are so...9 out of 10 are just snowflakes to the core?

Tyson: I get this, you know, I'd say on the regular, maybe once a month, one of my clients got a bad review. And I tell them what they need to do and that is we take out the merit of the review, we're just gonna assume the review was accurate. I don't care, I'm not getting into what he said, she said.​

But you need to own the review and you need to professionally respond and you need to take the high road. No good is gonna come of arguing or back-and-forth, which I unfortunately have had clients do against my recommendation. So, I make the recommendation to reply similar to this, "Dear so-and-so, we are extremely sorry that you had a bad experience in our office.

You know, we want to make it right. Our goal is to make sure that every person that comes in is treated like family, and we fell short. Please call..." and then insert dentist's name, "...at this number. We'd like to address any issues that you have."

So, you know, if I'm reading that, I'm a potential patient of that office, I'm gonna see, you know, crap happens, you know, things happen that are out of our control and somebody's not happy, okay. But what was the dentist's response? Okay, they took ownership of it and they want to fix the issue as opposed to attacking the person, which I've seen and, you know, okay, I'm going on to the next dentist if I see that. So, they really need to own the issue.

Howard: You know, I just went to my physician yesterday for my yearly physical and when I went in there, he was so...I thought he was just gonna die or cry, I mean, he was just visibly upset and he goes, "I'm so sorry. I can't believe this," he goes, "my nurse sent in the wrong blood deal, this is not what I needed on you."

And I knew it at the time because I only take one medication, it's thyroid, and when I saw another one the list, I said, "Are you sure this is right? Because, you know, it doesn't have thyroid," and then I thought, I don't know maybe it's been stable since 2005 and you don't want to check anymore.

But he told me that when that happens before people just go insane, I mean, they just lose it. And I just tell dentists, I mean, what percent...I mean, if someone asks you, Tyson, what percent of Americans would you say or just batshit crazy?

Tyson: I think to a point we all are about some things.

Howard: We all or about some things, I love that one. Yeah, we all are.

Tyson: Yeah.

Howard: And God dang it, you get a bad review, I mean, are you kidding me? You're gonna practice dentistry for 10, 20, 30, 40 years and you're not gonna accidentally order the wrong blood stuff, try a new lab, try anew...you know, that something goes completely wrong or it goes completely right, but the person receiving it is completely crazy.

I mean, you know, hell hath...when you go to a Farran family reunion, 50% of them should be under deep study by the Centers for Disease Control trying to figure out what went wrong. I assumed it was inbreeding, 50 years ago, I'm not for sure. So, I can't believe we've gone an hour. Is there any questions I wouldn't smart enough to ask or anything else you wanted to say?

Tyson: I think you did a great job of covering everything. You know, the advice that I give to dentists is when you're out there trying to get started with your online presence, go with somebody...when you do your research, find somebody that your comfortable with.

You know, I talked to dentists and sometimes they just are looking for something that's the cheapest and...okay, are you gonna just go to the cheapest guy to fix your teeth? You know, is that what you want to be seen for?

You wanna go where somebody is gonna give you quality. So, you know, do your research and find someone that you feel comfortable with. And, you know, I never pressure any anybody into working with me, I don't deal like that.

I'm just gonna talk with them, give them a recommendation and, you know, they need to feel comfortable with somebody they're paying to improve their online presence. So, you know, if they wanna look at what we have, go to getmyaudit.net, like I mentioned, and then put it their information, you know, and we'll send that over to them.

If they want to talk, they can talk. But you covered everything that I can think of. You know, the last thing we want to do is put off establishing an online presence because, you know, everyday it's just going to become more and more important to have.

Howard: Yeah, and I want to just add a couple things that...you know, when you're in a medical/dental building, you're gonna have to spend twice as much on this type of marketing. So, a great form of...why do you think all these big stores go in the mall? Because that's where the traffic is.

Tyson: Right.

Howard: And, my gosh, when you look at these four-lane intersections in Phoenix and Salt Lake, some of these intersections get 30,000, 40,000 cars a day. That's just like having 30,000, 40,000 hits on your website. So, if you go in a medical/dental building, you're gonna live in Tyson's house for the rest your life. Get visibility.

You know what's funny, I was reading this book, hundred years ago, this business guy said, "If you're not seen from the horse's trail, you don't exist," and now the horse is gone but it's the car. I was reading this deal, in New York City they're biggest public transportation problem was the depth of manure in the streets of New York City. And they would shovel to the side, on the sides it'd be six feet deep shoveling this stuff to the side.

Tyson: Wow.

Howard: So, you got to be seen from the automobile windshield. You got to have a retail location. And the other thing that the millennials do differently is that you're not getting immediate results. I mean, you build brand, you build advertising campaigns over years, and years, and years, You just can't come to Coolidge, Arizona and build a brand overnight.

It just doesn't work that way. It might work that way in your Instagram mind, or SnapChat, but that's not how it works in the real world. And so, when you do these marketing things, remember, it's just a daily 20-mile march, and you march 5 days a week, you march 50 weeks a year. And it's week-after-week, year-after-year, and 5, 10 years down the road, if you had the right strategy, your student loans are paid off and you're glad you went to dental school, and life is good.

And I just want to tell you about that 17-year-old boy of yours. I got four boys, they're 28, 26, 24, 22, I did not have a boy that did not stack a car around that sweet spot of 17. So, good luck with that, Tyson, Hope you have auto insurance on the car.

Tyson: You know, were somewhat lucky with our 17-year-old. He's intellectually disabled so he won't ever drive a car. He's a challenge but he is a joy.

Howard: Oh, right on, right on. My gosh, Zach was a...remember when Zach got his first car? He saved up forever and bought this beautiful, blue Mustang. It was the most gorgeous car. And his first trip out of the house was to Chick-fil-A or...

Male: He was actually on his way home from work.

Howard: Chick-fil-A, no, Chipotle.

Male: Oh, was it? Oh, yeah, yeah, yeah.

Howard: He got off work and then he went to Chipotle, pulled out of Chipotle parking lot and stacked the car. And I'm...my gosh.

Tyson: Oh.

Howard: Well, hey, seriously, Tyson, thanks for taking an hour out of your busy day and coming on the show and sitting with my homies. Thanks for posting on DentalTown, that's why I called you, you didn't call me. Remember there's no advertising on there. I asked him, he didn't ask me, there's no money changing hands. I'm big fan of you, big fan of your post. But thanks so much for coming on the show. I really appreciate. I hope you have a rocking hot day, buddy.

About the Author

Tyson Downs, the owner of Titan Web Agency, has years of experience working with small businesses and helping them meet their revenues goals. Prior to starting Titan Web Agency, he freelanced in SEO and Web Design while working in the corporate world. Tyson is a graduate of Brigham Young University, the father of 5, and a passionate bodybuilder.